Influence of parental eating disorder on children

It is now well established that children of parents who have psychiatric disorders are at risk of developing disturbances themselves (Rutter, 1989; Garmezy & Masten, 1994). Of particular concern is that these disturbances may persist well after remission of the parental disorder. Eating disorders occur commonly among women of child-bearing age (Szmukler, 1985; Fairburn & Beglin, 1990) and the prevalence seems to be rising (Treasure et al, 1996). Estimates indicate that at least 2% of women aged 16-40 suffer from bulimia nervosa or anorexia nervosa, and up to 4% when other eating disorders are considered (Fairburn & Beglin, 1990; Hoek, 1993). It is therefore surprising that the potential implications for their offspring have received so little attention until recently. Knowledge of whether these children are at risk and the mechanisms underlying any transmission of disturbance is important so that appropriate treatment can be instituted and preventive strategies put in place. There are a number of reasons why an eating disorder may potentially interfere with the quality of parenting. First, the core symptoms of eating disorders are extremely pervasive and potentially disruptive of daily activities and sensitive parenting. Particularly debilitating are the preoccupations with body shape, weight and food, which may draw parental attention away from the needs of their child. The behaviours which characterise eating disorders and which may disrupt harmonious parent-child interaction include episodes of binge eating, and the extreme behaviours to compensate for over-eating, such as vomiting, the use of purgatives and excessive exercise. Second, people with eating disorders have difficulties in their interpersonal relationships (Humphrey, 1989), and it is of concern that these difficulties may extend to their relationships with their children. Furthermore, particular stages of development may render children especially susceptible to the influence of parental eating disorders.